Why has trust in science and healthcare dropped and how can we reverse this trend? 

What happened to trust in science? Today’s healthcare landscape reflects many of the larger societal issues at play – it's politicized, fragmented and lacks proper discourse between opposing groups. In 2022, the Pew Research Center reported: “Overall, 29% of U.S. adults say they have a great deal of confidence in medical scientists to act in the best interests of the public, down from 40% who said this in November 2020.” What is more, the politicization of healthcare is contributing to a lack of trust in the U.S.

Even those within the system find pain points in the lack of clarity on the heavily involved relationship between healthcare and government. Take, for example, the U.S’s new vaccine development programme for the next generation of Covid vaccines, it is heavily funded, but not very regulated, continuing the confusing legislation rolled out by the Trump and Biden administrations during the COVID-19 pandemic. With less than a year until the 2024 election cycle, candidates from both parties are using buzzy healthcare topics to fuel their platforms.

Coupled with high emotions, a large spread of health-related misinformation and waning confidence in healthcare systems, the issue of a lack of trust in science is looming an ugly head after the pandemic cemented healthcare in the public eye. There are lessons to be learned from the pandemic, which also cast a spotlight on the urgent need to bring communities who have limited access into the healthcare system. To ensure that we improve health outcomes, we must transform our approach to educating and reaching people.

Misinformation about health is not limited to the U.S. It is a global threat to health equity by way of a lack of proper and truthful information. Especially in a time of international turmoil, global health equity faces multiple challenges. “Health misinformation is a serious threat to public health,” said Dr. Vivek H. Murthy, Surgeon General of the U.S, “It can cause confusion, sow mistrust, harm people’s health and undermine public health efforts.”

A recent study from USC found that the biggest influence in the spread of fake news was the structural foundations of social media platforms, which reward users who share information, rather than the individual attributes of users. The voices of authority and experience are often outweighed by active social 'influencers' with highly engaged followers.

Capturing attention and amplifying your posts gains more weight than the authenticity of what you are saying. The study found that “just 15% of the most habitual news sharers in the research were responsible for spreading about 30% to 40% of the fake news.” In sum, narrow cohorts with a mission can capture the greatest share of voice and become the voice of 'truth.'

There are four fundamental activities that are critical to combatting health misinformation and influencing the information landscape with huge consequences for individual healthcare outcomes:

Today, information is individualized and personalized, absorbed and filtered according to perceptions of personal relevance. As put recently in Forbes, consumers “want to feel like their favourite brands know them, understand them and care about them as people.” Information must, therefore, be personalized and not channelled from the top down. It is important that individuals feel they are respected and involved in health decisions. We are shifting to a much more individualized environment.

Health recommendations that are tailored, targeted and personalized resonate. The emergence of a personalized healthcare system requires a new framework that is built around the individual forecast, finds EY. The first phase is listening and establishing a dialogue and a two-way channel for exchanging views. New healthcare providers, positioned to serve patients in a hybrid environment, are increasingly marketing towards Millennials and Gen Z. Better Help, hims, Tia and Prenuvo are among the solutions flooding the market

There has also been government support for increasing telehealth practices, such as the grant awarded to the National Cancer Institute in August 2022 for $23 million to aid the launch of Telehealth Research Centers of Excellence (TRACE) across the U.S. In addition to creating systems that consider a patient’s lifestyle needs, there is an increasing demand for patient-specific treatments. According to Acumen Research & Consulting, “in 2022, the Worldwide Hyper Personalized Medicine Market was estimated at $2.1 trillion” and is projected to “surge to $6.7 trillion by 2032.” Major companies driving this market shift include 23andMe, BGI, Thermo Fisher Scientific and QIAGEN. We need to look to a new model of healthcare that is personalized and often virtual.

The tribalism that we experience in our fragmented society and in politics is deeply rooted in healthcare attitudes. Group identity is a defining factor in how people consider their healthcare options. Healthcare policy and decisions have become increasingly intertwined with politics. More than facts and stats, allegiance to political parties, education and rural/urban location often factor into how people absorb healthcare information. Therefore, the influence of small, niche factions can sway opinions and impact decisions. Furthermore, misinformation is 70 times more likely to be shared, amplifying the impact and entering the mainstream. To combat this, it is critical to find common values and set shared goals to create greater collaboration and trust across communities.

Culture is critical in shaping behaviour. Cultural intelligence is key to gleaning insights that help accelerate the adoption of best healthcare practices. It is not a one-size-fits-all system. Having an impact requires shaping messaging and narratives founded on cultural traditions and patterns. Community venues and information channels vary widely. In the US Black community, the voice of key leaders who interact through daily interactions are fruitful places to provide health guidance. Similarly, according to a report on communicating to the Hispanic Community by the CDC, “Collectivist values or group orientation permeates Hispanic life and individuals often look to one another for opinions. A collectivist orientation may serve as a valuable asset in terms of health promotion.”

Influencers in each community are different. The convincing voice of authority varies depending on culture. The Hispanic community, for example, tend to engage highly when it comes to interacting with influencer content. Non-white and Hispanic social media users have a stronger tendency to follow influencers, this is particularly evident among women aged 18-44. Hispanic male social media influencers demonstrate the greatest engagement with the influencers they follow and a willingness to offer their support financially. Peer influencers and role models are powerful, regardless of the depth of their healthcare knowledge. They can signal understanding and care and can be strong voices.

The University of Colorado Boulder published a report to understand how patient influencers communicate health literacy. The report found that “social media influencers hired by pharmaceutical companies play a positive role in patient education,” with the majority of participants (92%) saying that “they shared their content so that others ‘would not be susceptible to a lack of information or education.'" We can leverage social media channels to combat the small percentage that spew out misinformation by identifying micro-influencers with social authority and highly engaged followings and working closely with them in their communities to rebalance content towards more accurate facts and to encourage better healthcare behaviours.

Experimenting with new tools, such as wearables and AI health devices, can be useful ways to improve healthcare outcomes if properly introduced and if individuals see them as empowering their personal decisions. Over a quarter of the US population use wearable tech and the market for smart wearables in the US is positioned to grow 25.5% year-on-year in 2023. These technologies offer a variety of uses, from fitness trackers and health watches to ECG monitors, blood pressure monitors and biosensors. The growing popularity of wearables reflects a rising interest in personalized healthcare and a desire for more control over one's own well-being.

But these tools can also become drivers of mistrust if people suspect a lack of privacy, collection of private information and other intrusions. A Connectivity and Mobile Trends Survey conducted by Deloitte, found that 39% of Americans own a smartwatch or health and fitness tracker and that of those users, 40% are worried about the privacy of the data collected by their devices. To use this emerging set of assets that can be derived from wearables and new health technologies for improving behaviour, we will have to move on the trust imperative. By using secure analytics, companies can extract actionable insights from wearable data to provide a more personalized healthcare experience and promote healthy living within communities and society at large.

The information landscape has changed. Education and facts are not enough to shape attitudes and change behaviour. Being multi-faceted and inclusive is key. It is less about information and more about engagement. As communicators, we can reinvent our approach in an atmosphere of misinformation where healthcare is highly politicized, by shifting from a top-down approach to a more individualized model. Whereas this information was previously provided on a global or national basis, with a common set of messaging from large healthcare or governing bodies, a grassroots approach that considers community insights, local campaigns and trusted influencers can be much more resonant.

As we aim to achieve global health equity and get further into the 2024 election cycle, it’s important for us as communicators to address the hurdle of health misinformation head on. As we deal with this increasingly digital and information-heavy landscape and the speed at which misinformation can spread on social media, it’s important to focus on grassroots campaign communication strategies that encourage engagement and behavioural change, with the goal of a positive long-term impact on people’s lives and a step towards achieving global health equity.